Q: My breastfed baby spits up frequently. Is there something I'm eating that could be causing this? Could it be reflux? Or is this normal?
A: If your baby is spitting up, even if it's a frequent occurrence, it's rarely a sign of a serious problem. In fact, "In a healthy baby," according to the late Dr. Gregory White, previously a medical advisor to La Leche League, "spitting up is a laundry problem, not a medical problem." If your baby is gaining weight properly and otherwise developing normally, you probably have nothing to worry about, and likely the problem will lesson and eventually go away by the time baby is a year old.
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Still, it can be disconcerting if your nursing baby spits up a lot. You may be wondering if he or she is getting enough milk or if there is some problem with your breastmilk. Rest assured. There are several things you can do to help prevent frequent spitting up.
1) Let Gravity Help When Feeding
Basically, any position that causes the milk to go against gravity will help baby handle the flow of milk more easily, and cause him to swallow less air. Try nursing baby in the "football" hold with him looking at your breast and partially sitting up, facing you. Nursing lying down will allow baby to let extra milk flow out the side of his mouth. After a feeding, try holding him upright in a baby sling. Many Moms have found that their frequent spitters are helped when they're frequently held close to Mom's body in a soft carrier.
2) Finish The First Breast First
At the beginning of a feeding, your baby is getting the lower fat "foremilk" and later on, the higher fat "hindmilk". If you remove baby from the first breast before he pulls away and give him the other side, he may fill up with foremilk, causing some gassiness, fussiness, and more spitting up. Let him decide when he's done with the first breast, either by pulling away or falling asleep. If you have a very strong "letdown", or milk ejection reflex, then this is especially important. You may have an overabundant milk supply. Try keeping baby on one side for an entire feeding.
3) Pay Attention To Your Latch
Be sure baby is latched on properly. His mouth should be open wide and he should have a lot of areola (not just the nipple but surrounding tissue) in his mouth. If he is latched on well you will have no pain, and baby will swallow less air. It's also a good idea to burp a frequent spitter before offering him the second breast. Oftentimes a thorough burping will prevent spit up later.
4) Relax!
Frequent spitting up is often caused by an underdeveloped esophageal sphincter (fancy term for the muscles that keep food down). The problem will likely resolve as baby gets older.
Spitting up is rarely caused by something a nursing Mom ate. There is no one food that causes trouble in most or all breastfed infants. Nursing Moms worldwide eat a variety of foods (including spicy foods, garlic, dairy products and "gassy" foods like onions, cabbage and beans) and nurse healthy babies. Food allergies are rare in breastfed infants. If you have a strong family history of allergies, then your baby may be allergic to something that appears in your milk. Ask your health care provider for recommendations about changing your diet.
Fussiness can be caused by many different factors, including temperament. If you suspect that your baby's frequent spitting up is caused by Reflux, he may have some of the following symptoms: trouble gaining weight, difficulty breathing, gagging and extreme irritability. Ask your baby's Doctor about your baby's symptoms if you're unsure.